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A comparison of the prevalence and risk factors of complications in intracranial tumor embolization between the Japanese Registry of NeuroEndovascular Therapy 2 (JR-NET2) and JR-NET3

  • Original Article - Tumor - Other
  • Published:
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Abstract

Background

The Japanese Registry of NeuroEndovascular Therapy 2 (JR-NET2) and 3 (JR-NET3) were nationwide surveys that evaluated clinical outcomes after neuroendovascular therapy in Japan. The aim of this study was to compare the prevalence and risk factors of complications of intracranial tumor embolization between JR-NET2 and JR-NET3.

Methods

A total of 1018 and 1545 consecutive patients with intracranial tumors treated with embolization were enrolled in JR-NET2 and JR-NET3, respectively. The prevalence of complications in intracranial tumor embolization and related risk factors were compared between JR-NET2 and JR-NET3.

Results

The prevalence of complications in JR-NET3 (3.69%) was significantly higher than that in JR-NET2 (1.48%) (p = 0.002). The multivariate analysis in JR-NET2 showed that embolization for tumors other than meningioma was the only significant risk factor for complication (odds ratio [OR], 3.88; 95% confidence interval [CI], 1.13–12.10; p = 0.032), and that in JR-NET3 revealed that embolization for feeders other than external carotid artery (ECA) (OR, 3.56; 95% CI, 2.03–6.25; p < 0.001) and use of liquid materials (OR, 2.65; 95% CI, 1.50–4.68; p < 0.001) were significant risks for complications. The frequency of embolization for feeders other than ECA in JR-NET3 (15.3%) was significantly higher than that in JR-NET2 (9.2%) (p < 0.001). Also, there was a significant difference in the frequency of use of liquid materials between JR-NET2 (21.2%) and JR-NET3 (41.2%) (p < 0.001).

Conclusions

Embolization for feeders other than ECA and use of liquid materials could increase the complication rate in intracranial tumor embolization.

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Acknowledgments

JR-NET2: The authors would like to express heartfelt thanks to doctors who devoted their time to this investigation. The JR-NET Study Group: Principle Investigator: Nobuyuki Sakai, Kobe City Medical Center General Hospital, Kobe, Japan; Investigators: Akio Hyodo, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Japan (17C-1, 20C-2); Shigeru Miyachi, Nagoya University, Nagoya, Japan (17C-1, 20C-2); Yoji Nagai, Translational Research Informatics Center, Kobe, Japan (17C-1, 20C-2); Chiaki Sakai, Institute of Biomedical Research and Innovation, Kobe, Japan (17C-1, 20C-2); Tetsu Satoh, National Cerebral and Cardiovascular Center, Suita, Japan (17C-1, 20C-2); Waro Taki, Mie University, Tsu, Japan (17C-1, 20C-2); Tomoaki Terada, Wakayama Rosai Hospital, Wakayama, Japan (17C-1, 20C-2); Masayuki Ezura, Sendai Medical Center, Sendai, Japan (17C-1); Toshio Hyogo, Nakamura Memorial Hospital, Sapporo, Japan (17C-1); Shunji Matsubara, Tokushima University, Tokushima, Japan (17C-1); Kentaro Hayashi, Nagasaki University, Nagasaki Japan (20C-2); Co-Investigators: Toshiyuki Fujinaka, Osaka University, Suita, Japan; Yasushi Ito, Niigata University, Niigata, Japan; Shigeki Kobayashi, Chiba Emergency Medical Center, Chiba, Japan; Masaki Komiyama, Osaka City General Hospital, Osaka, Japan; Naoya Kuwayama, Toyama University, Toyama, Japan; Yuji Matsumaru, Toranomon Hospital, Japan, Yasushi Matsumoto, Konan Hospital, Sendai, Japan; Yuichi Murayama, Jikei Medical University, Tokyo, Japan; Ichiro Nokahara, Kokura Memorial Hospital, Kokura, Japan; Shigeru Nemoto, Jichi Medical University, Shimotsuke, Japan; Koichi Sato, Tokushima Red Cross Hospital, Tokushima, Japan; Kenji Sugiu, Okayama University, Okayama, Japan; Shinichi Yoshimura, Gifu University, Gifu, Japan; and Certified Specialist of Japanese Society of Neuoendovascular Therapy.

JR-NET3: The JR-NET3 Study Group: Co-Principle investigator: Nobuyuki Sakai, Kobe City Medical Center General Hospital, Kobe, Japan; Koji Iihara, Kyushu University, Fukuoka, Japan; Tetsu Satow, National Cerebral and Cardiovascular Center, Suita, Japan; Investigators; Masayuki Ezura, Sendai Medical Center, Sendai, Japan; Akio Hyodo, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan; Shigeru Miyachi, Aichi Medical University, Aichi, Japan; Susumu Miyamoto, Kyoto University, Kyoto, Japan; Yoji Nagai, Kobe University, Kobe, Japan; Kunihiro Nishimura, National Cerebral and Cardiovascular Center, Suita, Japan; Kazunori Toyoda, National Cerebral and Cardiovascular Center, Suita, Japan; Co-investigators: Toshiyuki Fujinaka, Osaka Medical Center, Osaka, Japan; Toshio Higashi, Fukuoka University, Fukuoka, Japan; Masaru Hirohata, Kurume University, Kurume, Japan, Japan; Akira Ishii, Kyoto University, Kyoto, Japan; Hirotoshi Imamura, Kobe City Medical Center General Hospital, Kobe, Japan; Yasushi Ito, Shinrakuen Hospital, Niigata, Japan; Naoya Kuwayama, Toyama University, Toyama, Japan; Hidenori Oishi, Juntendo University, Tokyo, Japan; Yuji Matsumaru, Tsukuba University, Tsukuba, Japan; Yasushi Matsumoto, Konan Hospital, Sendai, Japan; Ichiro Nakahara, Fujita Medical University, Aichi, Japan; Chiaki Sakai, Hyogo College of Medicine, Nishinomiya, Japan; Kenji Sugiu, Okayama University, Okayama, Japan; Tomoaki Terada, Showa University Fujigaoka Hospital, Kanagawa, Japan; Shinichi Yoshimura, Hyogo College of Medicine, Nishinomiya, Japan; and Certified Specialist of Japanese Society of Neuroendovascular Therapy.

Funding

JR-NET2 was supported by research grants for cardiovascular diseases (17C-1, 20C-2) from the Ministry of Health, Labor, and Welfare of Japan. JR-NET3 was supported in part by a Grant-in-Aid (Junkanki-Kaihatsu H24-4-3) from the National Cerebral and Cardiovascular Center, Japan, and by Hatazaki Foundation, Kobe, Japan.

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Authors and Affiliations

  1. Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan

    Tomohito Hishikawa, Kenji Sugiu, Satoshi Murai, Yu Takahashi, Naoya Kidani, Shingo Nishihiro, Masafumi Hiramatsu & Isao Date

  2. Department of Neurosurgery, National Cerebral and Cardiovascular Center, Osaka, Japan

    Tetsu Satow

  3. Department of Neurosurgery Graduated School of Medical Sciences, Kyusyu University, Fukuoka, Japan

    Koji Iihara

  4. Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan

    Nobuyuki Sakai

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  1. Tomohito Hishikawa
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  2. Kenji Sugiu
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  4. Yu Takahashi
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  8. Isao Date
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  9. Tetsu Satow
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on behalf of the JR-NET2 and JR-NET3 study groups

Corresponding author

Correspondence to Tomohito Hishikawa.

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The authors declare that they have no conflict of interest.

Ethical approval

The study protocols of JR-NET2 and JR-NET3 were approved by the institutional review board at Kobe City Medical Center General Hospital.

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Because this was a retrospective noninvasive study, written informed consent was not obtained from patients.

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Hishikawa, T., Sugiu, K., Murai, S. et al. A comparison of the prevalence and risk factors of complications in intracranial tumor embolization between the Japanese Registry of NeuroEndovascular Therapy 2 (JR-NET2) and JR-NET3. Acta Neurochir 161, 1675–1682 (2019). https://doi.org/10.1007/s00701-019-03970-w

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  • DOI: https://doi.org/10.1007/s00701-019-03970-w

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